评价直接凝血酶抑制剂治疗的患者肝素诱发的血小板减少症。
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党CH、Durkalski六世、Nappi JM
评价直接凝血酶抑制剂治疗的患者肝素诱发的血小板减少症。
药物治疗。2006年4月26日(4):461 - 8。
- PubMed ID
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16553503 (在PubMed]
- 文摘
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研究目的:评价疗效、安全性、和相关的成本与argatroban抗凝,bivalirudin, lepirudin管理病人肝素诱发的血小板减少症(打击)或推测。设计:回顾性病历审查。背景:大学附属教学医院。病人:42例住院1月1日至12月31日,2004年,并与bivalirudin治疗,argatroban或lepirudin至少24小时。测量及主要结果:主要结果是激活的时间来达到期望的目标局部血栓形成质时间(aPTT)。次要结果aPTT测量在治疗范围内的数量,成本,治疗持续时间、临床结果和不良事件。42符合入选标准的患者,24日收到bivalirudin, 13日收到argatroban 5收到lepirudin。病人接受bivalirudin达到治疗aPTTs达到他们早于那些接受argatroban或lepirudin (8.5 vs 14至24小时,分别,p = 0.124)。治疗的平均百分比aPTTs /病人最大argatroban组(62%),其次是bivalirudin(57%)和lepirudin(29%)组(p = 0.062)。平均药物成本/天/病人lepirudin组大于其他组,而平均实验室成本组之间是相似的。 Treatment duration was longer with argatroban than with bivalirudin or lepirudin. Bleeding rates were similar in the argatroban and bivalirudin groups, but higher than in the lepirudin group. A composite of clinical outcomes (deep vein thrombosis, nonfatal myocardial infarction, nonfatal stroke, limb amputation, and all-cause mortality) were similar among the three groups. CONCLUSION: All three drugs were effective as anticoagulants for patients with HIT or presumed HIT. Based on average use and average wholesale price, bivalirudin cost less per day than the other two agents. Although not yet approved by the United States Food and Drug Administration for management of HIT, bivalirudin appears to be a viable treatment alternative for anticoagulation therapy.
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